Black Men at Highest Risk of Colon Cancer
- Colon cancer in Black men often diagnosed in a later, more aggressive stage
- Younger people — under 50 — across all gender and race are also being diagnosed with greater frequency
- While researchers work to tease out causes, colonoscopy screenings, starting at age 45, is the best way to prevent the disease or diagnose it early
And as the tragic death of Chadwick Boseman, 43, illustrates, the rate of colon cancer in younger people is rising. Diagnosed with stage 3 colon cancer in 2016 at 39, Boseman was well below the recommended screening age of 45 for those with no other risk factors.Read More
While access to care, cancer screening, and other socioeconomic factors are driving this disparity, there’s more to the story of why Black patients — and men, in particular — are still more likely to be diagnosed at an earlier age and with more advanced disease.
One disturbing observation showed a difference in follow-up rates after colonoscopy. If you’ve had a colonoscopy, make sure you receive results from your doctor. If pre-cancerous polyps were removed, you’ll need a follow-up screening in 3-5 years, not 7-10.
But even after exploring factors like dietary fiber intake and potential gene mutations, the study concluded, “we still know relatively little about the molecular mechanisms underpinning why African Americans with colorectal cancer are more likely to die from the disease than other ethnic groups.”
Black Men and Colonoscopies
This lag in research means Black men, especially, need to be vigilant about colon cancer screening. And while a colonoscopy can also eliminate pre-cancerous polyps, Black men are more likely to avoid this lifesaving test.
Until recently, screening guidelines noted that all men should get colonoscopies starting at age 50, and that Black men should get them beginning at age 45. But new guidelines suggest everyone should get screened beginning at age 45, Dr. Heather Yeo, a colorectal surgeon at Weill Cornell Medical Center, tells SurvivorNet.
Those with a family history of colon cancer should begin to screen approximately 10 years earlier than the standard age of 45.
Colon Cancer: A Family Secret?
But don’t assume you’ll know whether a close relative has been diagnosed with colon cancer, “It didn’t come up until we started asking questions,” TODAY Show host, Craig Melvin, told SurvivorNet, after his brother was diagnosed with colon cancer.
TODAY host, Craig Melvin discovered his family history of colon cancer only after his brother, Lawrence, was diagnosed with the disease.
“One of the things that we found out after my brother was diagnosed is that there was, in fact, a family history of colorectal cancer,” Melvin says.
“That’s the case in a lot of families. People don’t like talking about their colons or their rectums or blood in their stool,” Melvin added. “These aren’t conversations that families have.”
Will Smith Tackles Colonoscopy Avoidance
When actor Will Smith turned 50 he tackled this reluctance head-on, sharing his colonoscopy in a hilarious video: “I’m 50 so people need to look up my stuff,” Smith said.
The reason for this avoidance may be cultural, Dr. Zuri Murrell, Director of the Cedars-Sinai Colorectal Cancer Center told SurvivorNet, adding, “You shouldn’t die from embarrassment.”
“You shouldn’t die from embarrassment,” says Dr. Zuri Murrell, Director of the Cedars-Sinai Colorectal Cancer Center, who says one-third of those eligible for colon cancer screening aren’t getting it.
In the video, Smith, now 51, walks viewers through the colonoscopy prep process. “For the past 24 hours, my diet has consisted of clear liquids and over-the-counter laxatives.”
Before the procedure, he got personal. “This is my gown. It opens in the back so my a** is gonna be out … so they can get to it easy,” Smith said, and later referred to his doctor as “the Martin Scorscese of my ass.” The procedure requires a camera to search for colon cancer polyps.
Colonoscopy Provides Both Screening and Prevention
When you have a colonoscopy, the gastroenterologist performing the procedure is looking at the inside of your colon to detect polyps.
Polyps are small growths in the colon that have the potential to develop into cancer. A polyp that is found during a colonoscopy is removed, which can actually prevent the development of cancer. A pathologist determines if it is a benign polyp or if it is colon cancer. Almost all polyps that are removed are precancerous, meaning that they have not yet progressed to cancer.
Dr. Zuri Murrell, explains how polyps are removed during a colonoscopy. A pre-cancerous polyp means you’ll need another colonoscopy in 3-5 years.
When polyps are removed during a colonoscopy, they are small growths in the colon that are not yet cancerous, but have the potential to develop into cancer. A pathologist determines if it is a benign polyp or if it is colon cancer. Almost all polyps that are removed are precancerous, meaning that they have not yet progressed to cancer.
The American Cancer Society recently recommended that beginning at age 45, patients undergo a colonoscopy every 10 years. However, more frequent colonoscopies are recommended if a polyp is found.
While most major national organizations put no upper age limit on colonoscopy screening, government guidelines suggest people 76 and over talk to their doctor about whether further screening is needed.
Depending on the size and number of polyps, it is recommended that patients undergo a repeat colonoscopy within three to five years, and maybe more frequently depending on the individual risk of the patient.
Close The Gap
It’s a sad fact of life in America that Black people are much more likely to die of cancer. Over the last two years, SurvivorNet has been focused on raising awareness about these huge disparities in cancer when it comes to race. The initiative is called “Close The Gap.”
We are very happy to have NYU Langone and The Perlmutter Cancer Center as partners in this effort. Much more to come here… stay tuned. Please let us know your ideas on how to raise awareness. Get in touch at [email protected]